Meeting of the Parliament 25 March 2014
The debate has been very useful, and I am happy to say that we are happy to accept both the Labour and the Conservative Party amendments. The debate has been very helpful for the reasons that Nanette Milne outlined in her speech. Our national vaccination programmes are largely taken for granted, in that they happen and are very effective. They are programmes in which, if one element ever went wrong, that would very quickly become a major public health challenge and concern. That staff, particularly in our public health sector and primary care sector, have managed our vaccination programmes so successfully over many years is to their tremendous credit. We can rightfully be very proud of that.
As members have highlighted, the vaccination programmes extend from newborn babies right through to older members of our community. However, as a number of members said, they do not stand still. As a result of national and global vaccination programmes, we have seen the effective eradication of some conditions, such as smallpox, to which Richard Simpson referred, and polio, which has been eradicated in Europe since 2002. All those things are the result of good, effective immunisation and vaccination programmes. We are very lucky to have very safe and reliable vaccination programmes in Scotland that ensure that we can have confidence in how the process operates.
I want to pick up in particular the issue that Richard Simpson and Graeme Pearson highlighted: the concern about pressure on staff and the demands that the vaccination programmes place on them. I am acutely aware of the pressure that our staff are under in delivering the vaccination programmes, because I am extremely conscious that, in order to maintain public confidence in our immunisation programmes, we need to ensure that those programmes are robust and that they apply effectively the science for which they have been developed right across the country.
I will give members an illustration of the nature of some of the challenges that we face. An ever-increasing number of vaccinations have been introduced. A significant number of those vaccinations and immunisations are one-offs, or perhaps one, two or three immunisations are required at given times in a young person’s or older person’s life, but the flu vaccination programme must take place every single year. The introduction and extension of that programme to those between the ages of two and 17 almost overnight doubles the numbers in our childhood immunisation programme. That is a significant logistical challenge.
In order to deal with that challenge, in the first year we have used a number of different pilots in different health board areas to test out different approaches and to get staff feedback on which is the most appropriate. The pilots cover different age groups to find out what is the best approach for particular groups. For example, older kids can, under supervision, self-immunise in class. Other approaches are being taken with different age groups in primary schools, too. We are working with staff to identify the best way to proceed.
Another challenge is that we very often require the staff to undertake immunisation and vaccination programmes only for a short time over a given period during the year and not throughout the year. We will therefore introduce the programmes over a number of years. I know that some people want that to happen much quicker, but we should take our time to get it right and to work with the staff to ensure that we have a robust system and that the public can have confidence in the processes that we have in place.
Jackson Carlaw made an extremely important point. The approaches that we often take to different immunisation programmes are not a consequence of Government choice; rather, they are led by expert advice that is presented to Government. We react and respond to the expert advice that we receive, whether from the Joint Committee on Vaccination and Immunisation or from Health Protection Scotland. I am certainly not an expert in any shape or form, and in this area we are very much led by experts.
Richard Simpson mentioned a catch-up programme for kids who may have lost out by not having the MMR vaccine in the 1990s. Our approach is based on expert advice provided to ministers by Health Protection Scotland. If Health Protection Scotland believed that a different approach should be taken, I would be more than happy to take that approach. I reassure members that no complacency exists whatsoever. We are led by experts on the issue, and if the advice changes we will respond to that positively, for the very good reason that that is what we should do.
Graeme Pearson mentioned the shingles vaccination and the concerns expressed by some older people about whether they are entitled to that vaccination because of their age, and when they will be vaccinated. The introduction of that vaccination programme is based on JCVI advice. We will start off with people who have turned 70 and those who are 79, to catch them before they turn 80. Over the next three to four years, we will run a catch-up programme for those in between. I recognise that people may be concerned that they have not been vaccinated yet, but we are taking what the experts have recommended to us as the most robust approach. It is fair to say that there is limited availability of the shingles vaccine because only one manufacturer makes the vaccine. That is part of the reason for our roll-out programme.
I am also conscious that our vaccination programmes must be placed in the context of the international health agenda. Some members may be aware that the wild poliovirus was identified recently in Syria, which immediately resulted in advice from the World Health Organization: if a single case is identified in Europe, where polio has been eradicated, that will result in the release of oral polio vaccination stockpiles in Scotland.
We must take forward our vaccination and immunisation programmes in that global context. We must ensure that we have a robust system in place, so that can respond—in a safe and informed way—when new vaccines come along.
All members who spoke in the debate recognise that Scotland is well placed to build on the success of its vaccination programmes over recent years. This Government intends to build on that success, so that we gain the public health benefits that have come from having vaccination programmes in Scotland over the past several decades.